Three-Day Dietary Record

Three-Day Dietary Record
Name: __________________________________
Date: _________________________
It is important that this record be both accurate and representative of your normal dietary intake.
Thus it is essential that you do not alter your normal eating habits in any way and that you record as
precisely as possible every single item that you consume (this includes water, vitamins, condiments,
etc.). To do so, you must follow a few simple instructions (listed below). The purpose here is to
correctly record and quantify your normal intake, not to judge it. If you change your eating habits in
any way, then we cannot accurately analyze your typical diet. The procedure may seem somewhat
cumbersome, but remember, it is only three days.
INSTRUCTIONS
re-measure what’s left and record the difference.
Keep a pen and paper with you at all times to record
your intake including food item, quantity, and notes.
This is imperative as snacks are typically consumed
unpredictably and, as a result, it is impossible to record
them accurately unless your recording forms are nearby.
Record combination foods separately (e.g., hot dog, bun,
and condiments) and include brand names of food items
(list contents of homemade items) whenever possible.
Use a small food scale if you have one, or use standard
measuring devices (e.g., measuring cups, measuring
spoons) to record the quantities consumed as accurately
as possible. If you do not eat all of the item (for instance
a portion of an apparently delicious hastily prepared
casserole of leftovers that turned out to be not so delicious),
For packaged items, use labels to determine quantities.
Record three days that are representative of your normal
intake. Therefore if your weekdays are different from your
weekends, pick two weekdays and one weekend. Likewise,
if your M, W, and F are different from your T and Th and all
these days are different from your Sat and Sun, you should
pick one day to represent each unique schedule.
EXAMPLE: DIETARY RECORD: DAY 1
FOOD ITEM
QUANTITY
NOTES
Breakfast
2 pieces of toast
2 pc
Margarine
1T
Orange Juice
6 oz
Lunch
Small pizza
400 g
Pepperoni, mushroom, cheese
Dinner
Chicken
6 oz
Baked potato
6 oz
Mixed vegetables
1c
© 2012 Precision Nutrition precisionnutrition.com
Peas, carrots, corn
DIETARY RECORD: DAY 1
FOOD ITEM
(Include brand names)
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
© 2012 Precision Nutrition precisionnutrition.com
QUANTITY
(g, mL, tablespoons [T],
teaspoons [t], cups [c], etc.)
NOTES
(Include ingredients & amounts of homemade items)
DIETARY RECORD: DAY 2
FOOD ITEM
(Include brand names)
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
© 2012 Precision Nutrition precisionnutrition.com
QUANTITY
(g, mL, tablespoons [T],
teaspoons [t], cups [c], etc.)
NOTES
(Include ingredients & amounts of homemade items)
DIETARY RECORD: DAY 3
FOOD ITEM
(Include brand names)
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
© 2012 Precision Nutrition precisionnutrition.com
QUANTITY
(g, mL, tablespoons [T],
teaspoons [t], cups [c], etc.)
NOTES
(Include ingredients & amounts of homemade items)